{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T13:48:56Z","timestamp":1758980936192,"version":"3.37.3"},"reference-count":71,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T00:00:00Z","timestamp":1484524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J intellect Disabil Res"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intellectual disability and patient activation may be important drivers of inequities in health service access and health outcomes for people with intellectual disability transitioning from prison to the community. We assessed the association between intellectual disability and patient activation after prison release and examined whether this association varied, depending on whether intellectual disability was identified prior to prison release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Overall, 936 prisoners were screened for intellectual disability by using the Hayes Ability Screening Index and completed the Patient Activation Measure (PAM) within 6\u00a0weeks of prison release and again at 1, 3 and 6\u00a0months post\u2010release. We estimated the association between intellectual disability status and PAM scores by using a multilevel linear model, adjusting for sociodemographic, behavioural, health and criminogenic factors. We used propensity score matching to estimate the impact of being identified with intellectual disability prior to release from prison on the change in mean PAM score after prison release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with those who screened negative for intellectual disability, ex\u2010prisoners who screened positive, both with and without prior identification of intellectual disability, had significantly decreased mean PAM scores [(<jats:italic>B<\/jats:italic>\u00a0=\u00a0\u22124.3; 95% CI: \u22126.3, \u22122.4) and (<jats:italic>B<\/jats:italic>\u00a0=\u00a0\u22124.5; 95% CI: \u22126.8, \u22122.3), respectively] over 6\u00a0months of follow\u2010up. Among those who reported being identified with intellectual disability prior to release from prison, a significant increase in PAM score at the 6\u2010month follow\u2010up interview (<jats:italic>B<\/jats:italic>\u00a0=\u00a05.89; 95% CI: 2.35, 9.42; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001) was attributable to being identified with intellectual disability prior to release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ex\u2010prisoners screening positive for possible intellectual disability have decreased patient activation for at least 6\u00a0months after release from prison. However, individuals whose possible intellectual disability is unidentified appear to be particularly vulnerable. Incarceration is a pivotal opportunity for the identification of intellectual disability and for initiating transitional linkages to health and intellectual disability\u2010specific community services for this marginalised population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jir.12349","type":"journal-article","created":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T09:14:13Z","timestamp":1484558053000},"page":"939-956","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Intellectual disability and patient activation after release from prison: a prospective cohort study"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5702-372X","authenticated-orcid":false,"given":"J. T.","family":"Young","sequence":"first","affiliation":[{"name":"Melbourne School of Population and Global Health The University of Melbourne  Parkville Australia"},{"name":"Centre for Health Services Research, School of Population Health The University of Western Australia  Perth Australia"},{"name":"National Drug Research Institute Curtin University  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Cumming","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, School of Population Health The University of Western Australia  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"van Dooren","sequence":"additional","affiliation":[{"name":"Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute\u2010UQ University of Queensland  South Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. G.","family":"Lennox","sequence":"additional","affiliation":[{"name":"Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute\u2010UQ University of Queensland  South Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Alati","sequence":"additional","affiliation":[{"name":"School of Public Health and Centre for Youth Substance Abuse Research University of Queensland  Herston Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. J.","family":"Spittal","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health The University of Melbourne  Parkville Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Brophy","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health The University of Melbourne  Parkville Australia"},{"name":"Mind Australia  Heidelberg Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. B.","family":"Preen","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, School of Population Health The University of Western Australia  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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